Observational studyJournal of medical Internet research2025
Costs and Outcomes of a Therapist-Guided Internet-Delivered Cognitive Behavioral Therapy: Multicenter Observational Study.
Observational study in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Therapists' time allocation in guided digital mental health interventions - A scoping review and case study.Internet interventions · 2026Review
- The self-directed patient in guided internet-delivered CBT: a qualitative study of patient role expectations.Frontiers in psychology · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTherapist-guided internet-delivered cognitive behavioral therapy (iCBT) has demonstrated efficacy and potential cost-effectiveness in treating depression, anxiety, and panic disorder in randomized controlled trials (RCTs). However, evidence of its outcomes and costs in routine care settings on a national level remains limited.
objectiveWe aimed to assess the program costs and outcomes of therapist-guided iCBT for depression, social anxiety, and panic disorder posttreatment (T2) and at 6-month follow-up (T3) in a broad context, in addition to exploring how the program's costs and effects vary by hospital.
methodsThis single-arm observational study analyzed patient-reported data collected from routine care between 2021 and 2024 in 4 hospitals in Norway. The symptom severity of depression, social anxiety, and panic disorder was measured using the 9-item Patient Health Questionnaire (PHQ-9), the Social Phobia Inventory (SPIN), and the Panic Disorder Severity Scale (PDSS), respectively. Generic health-related quality of life (HRQoL) was measured with the EQ-5D-5L, while work and social functioning were measured with the Work and Social Adjustment Scale (WSAS) and sick leave days. Mixed effects models estimated changes in outcomes over time and between hospitals. Hospital-specific annual program costs per patient were estimated based on infrastructure and therapist guidance expenses. The economic evaluation was performed with a hospital perspective and extended to a societal perspective by examining sick leave days.
resultsData from 565 participants showed substantial improvements across all outcomes at T2 and T3. At T2, 102 (35.1%) participants responded positively to treatment (depression: 44/140, 31.4%; social anxiety: 21/79, 26.6%; panic disorder: 37/72, 51.4%), and 66 (23.7%) achieved remission (depression: 17/139, 12.2%; social anxiety: 26/73, 35.6%; panic disorder: 23/67, 34.3%). Regarding work and social functioning, 97 (33.0%) patients responded positively to the treatment and 60 (23.0%) achieved remission, as measured by the WSAS. Patients reported a mean reduction of 3.2 sick leave days (95% CI -5.4 to -0.9) at T2 and 7.7 sick leave days (95% CI -11.5 to -3.9) at T3. EQ-5D-5L utility scores increased by a mean of 0.11 (95% CI 0.08-0.13) at T2 and 0.12 (95% CI 0.09-0.15) at T3. Patient-reported outcomes were consistent across time points and hospitals and robust to sensitivity analyses accounting for patient and hospital characteristics and missing data scenarios. The mean total program costs per patient were US $1030.12 (SD 451.6), which varied by location (US $636.41-$2152.47), mostly due to differences in patient volume.
conclusionsThis study confirms the potential of therapist-guided iCBT to relieve symptom severity and improve well-being across different health service providers when implemented as part of routine specialist health care. The observed variance in costs per patient between hospitals underscores the importance of patient volume to optimize efficient use of resources.
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